An ingrown toenail is a common problem faced by many people. It can be painful and uncomfortable, disrupting daily life, work, and sports activities. Infections, ingrown toenails can contaminate items like socks, bed linens, slippers, and towels, and can also lead to household hygiene problems. Ingrown toenails can be the beginning of infections that can be difficult to control and can be life-threatening for people with systemic diseases (such as diabetes, vascular disease, and those with compromised immune systems). Ingrown toenails can occur in any toe, but most commonly occur in the big toe. An ingrown toenail can occur when the nail plate arches on one or both sides as it grows, soft tissue overhangs the nail plate, and the nail plate grows into the adjacent skin. An ingrown toenail initially presents as pain when wearing shoes. Over time, the infection, caused by bacteria entering through the compromised skin, can lead to sweating, redness, discharge, and the tissue at the edge of the nail extending and spreading onto the nail plate. The tissue at the edge of the nail overhangs the nail plate, complicating the situation and creating a vicious cycle. Nails normally develop at the nail root, in a part of the nail called the germinal matrix, located under the skin, and grow through the nail bed toward the fingertip. Sometimes, the tips of the nails indent from the sides, or the nail may become completely ingrown, not just at the corners. Consequently, an ingrown, inflamed, and weeping nail can make daily life difficult. If left untreated, the inflammation can spread to deeper tissues and cause serious problems.

What Causes Ingrown Nails?

There are many causes of ingrown nails. The most important of these are improper nail cutting and improper footwear. Excessive sweating, conditions that cause edema and swelling in the feet and soft tissues, obesity, repetitive impacts, and nail deformities due to fungal infections are predisposing factors for ingrown nails. The best way to prevent ingrown nails is through proper nail trimming, cleanliness, and proper footwear. Ingrown nails and other toe deformities are very rare in primitive societies that do not wear shoes. This result suggests that some foot problems are shoe-related. To address nail problems, it's important to avoid wearing tight, hard, and hard shoes. Wearing appropriate footwear and sweat-wicking cotton socks is especially important during sports activities that involve increased stress and humidity. Nails should not be cut straight across, but rather should be cut long enough to extend about 1 mm beyond the skin of the toetip. Nail corners should be cut squarely, not rounded. Ingrown nails are a common problem in children. Ingrown nails in children occur from birth due to a problem with the nail bed, which allows the nail to grow properly. Unlike adults, they appear with the first nail growth following birth and can persist throughout the child's life.

Which Medical Specialty Deals with Ingrown Nails?

First of all, it's important to understand that ingrown nails and other nail problems are medical conditions. Orthopedists, dermatologists, and podiatrists treat nail problems. Dermatologists specialize in the medical aspects of nails, orthopedists in the surgical aspects, and podiatrists aim to address foot problems within certain limits through basic foot care.

How Should an Ingrown Nail Be Treated?

Comorbidities should be questioned about any individual experiencing an ingrown nail or nail problem. In patients with diabetes, vascular problems, or those taking immune-suppressing medications, untimely, incorrect, or incomplete intervention can lead to irreversible consequences. Extreme caution is essential in such patients, and a systematic treatment approach is implemented. After listening to the patient and questioning their current medical condition, a detailed foot and nail examination is performed. Factors that contribute to ingrown nails, such as foot and toe deformities, nail deformities, fungal infections, excessive sweating, and moisture on the feet, are identified. The ingrown nail is examined to determine the stage or grade of the disease. This staging or grading is important for determining the treatment plan, the type of treatment, and predicting potential problems during treatment. Staging or grading is based on the duration of the problem, the presence of nail deformities, the presence and severity of infection, the presence of skin protruding from the edge of the nail plate, and the presence of bodily reaction tissue.